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This is VAERS ID 1048245

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1048245
VAERS Form:2
Age:95.0
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: General physical health deterioration

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-03
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: General physical condition decreased
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021164541

Write-up: General physical condition deterioration; This is a spontaneous report from a non-contactable physician downloaded from the Agency Regulatory Authority-WEB, Regulatory Authority number DE-DCGMA-21187965. A 95-year-old female patient was vaccinated with bnt162b2 (COMIRNATY, lot# unknown), the first dose on an unspecified date and the second dose on 22Jan2021, both via an unspecified route of administration at single dose for prophylactic vaccination. Medical history included general physical condition decreased since 01Jan2021 and ongoing. Concomitant medication was not reported. The patient experienced general physical condition deterioration after 1st on an unspecified date with outcome of unknown. 13 days after the second dose of vaccination the patient developed general physical condition decreased on 03Feb2021 with outcome of fatal. The patient was dead on 03Feb2021 due to general physical condition decreased. It was not reported if an autopsy was performed. Causal relationship between the event and the administration of bnt162b2 was assessed as "C. Inconsistent causal association" by the Regulatory Authority. Reporter comment: General physical condition deterioration after 1st and 2nd vaccination, but also fragile before that. The causal relationship cannot be clearly established, the general physical condition was also fragile beforehand, but significantly reduced after the two vaccinations. Temporal Connection exited (03Feb2021) after 2nd vaccination (22Jan2021). No follow-up attempts are possible, information on lot/batch number cannot be obtained.; Reporter''s Comments: General physical condition deterioration after 1st and 2nd vaccination, but also fragile before that. The causal relationship cannot be clearly established, the general physical condition was also fragile beforehand, but significantly reduced after the two vaccinations. Temporal Connection exited (03Feb2021) after 2nd vaccination (22Jan2021).; Reported Cause(s) of Death: General physical condition deterioration

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